The fourth meeting of the Emergency Committee under the International Health Regulations (IHR) (2005) regarding the international spread of wild poliovirus in 2014 - 15 was convened via teleconference by the Director-General on 17 February 2015. The following IHR States Parties submitted an update on the implementation of the Temporary Recommendations since the Committee last met on 13 November 2014: Cameroon, Equatorial Guinea, Pakistan and the Syrian Arab Republic.

The third meeting of the Emergency Committee under the IHR (2005) regarding the international spread of wild poliovirus in 2014 was convened by the Director-General through electronic correspondence from 2 through 7 November 2014.1 The following IHR States Parties submitted an update on the implementation of the Temporary Recommendations since the Committee last met on 31 July 2014: Cameroon, Equatorial Guinea, Pakistan and the Syrian Arab Republic.

Eighteen months ago, as 2012 drew to a close, optimism was running high for the Global Polio Eradication Initiative. Polio transmission in India had been interrupted. The three remaining endemic countries (Pakistan, Nigeria, Afghanistan) had made significant programmatic improvements. Some believed that success was imminent; that polio would soon be history.
Within a matter of months, this optimism quickly unwound:

• Targeted killing of polio vaccinators in Pakistan shocked the world and created major operational constraints.

Pakistan continues to be the country with most polio cases in the world this year. This week, five new cases were reported (two wild poliovirus type 1 – WPV1, and three circulating vaccine-derived poliovirus type 2 – cVDPV2). Four of the cases are from Federally Administered Tribal Areas (FATA) and one is from Gadap, greater Karachi.

The Strategic Advisory Group of Experts on Immunization (SAGE) has met in Geneva on 1-3 April to discuss measures to prevent further international spread of polio, progress in eliminating wild and vaccine derived poliovirus and the status of the preparation for global OPV2 withdrawal. Final recommendations will be published in the Weekly Epidemiological Record.

In Cameroon, two new wild poliovirus type 1 (WPV1) cases are reported this week, from 2014. The new cases confirm continued transmission of this strain and geographic expansion of infected areas following detection of four cases in October.

Newsweek Pakistan published an in-depth interview with Dr Hamid Jafari, WHO, about the current situation of polio eradication in Pakistan. The interview can be accessed here.

The first four cases wild poliovirus cases type 1 (WPV1) have been reported for 2014. All cases were reported from North Waziristan, FATA, Pakistan. North Waziristan is the district with the largest number of children being paralyzed by poliovirus in the world. As long as polio still exists in reservoirs like North Waziristan, the world will always be at risk of outbreaks.

India will reach a great milestone in polio eradication on 13 January - three years since its last case of wild poliovirus! India was once thought to be the most difficult country in which to achieve polio eradication.